1. Field of the Invention
This invention relates to surgical methods for anchoring and implanting devices and soft tissues in the body, such as in a knee joint. The invention also includes a surgical kit with instructions and tools for practicing the methods.
2. Description of the Prior Art
Surgical procedures for anchoring devices in a target location and for implanting soft tissues therein include procedures for replacing damaged tissues such as ligaments and tendons. For example, with reference to FIGS. 1-5, one such procedure is a technique for replacing a damaged anterior cruciate ligament (ACL) (24) in a human knee joint (20). Normally, in executing this procedure, a first step is to clean the surface of the joint and remove the damaged ACL. Thereafter, two co-axial passageways or tunnels (26, 28) are created in the knee joint: a generally upward-sloping tunnel (28) in the tibia (32) and a co-linear tunnel (26) in the condyle of a femur (30). To facilitate securing a replacement ligament (22) in the condyle of a femur, a third passageway or tunnel (34) is opened in the condyle of a femur, substantially transverse to tunnel (26) in the condyle of a femur.
To secure the replacement ligament (22) in the condyle of a femur (34), the or graft loop is folded on a flexible suture (36) and pulled through tunnel (26) from the tibia, to a position where a fold (44) in the ligament or graft loop is substantially in line with the longitudinal axis of the transverse tunnel (34). Once in this position, an anchoring device (40) such as a screw is inserted through transverse tunnel (34) and tightened against the ligament, thus securing the ligament or graft loop in the condyle of a femur. This method is described in co-pending U.S. patent application Ser. No. 10/822,101, having a filing date of 8 Apr. 2004, hereby incorporated by reference in its entirety.
With reference to FIG. 5 which is a diagrammatic representation of a side view of the transverse tunnel (34) intersecting the generally upward tunnel (26) in a condyle of a femur (30), since the replacement ligament or graft loop (22) is folded on the suture (36) and pulled through the tunnel (26), an extended kink (42) may develop in the ligament or graft loop just in line with the longitudinal axis of the screw (not shown) in the intersecting tunnel (34). Thus, on attempting to engage the screw to secure the ligament or graft loop in the condyle femur, the ligament or graft loop being soft and easily damageable can be punctured and weakened at the fold as the screw or another instrument is forced through the kink.
Further, since this procedure is performed in a confined space with limited visibility and maneuverability, it is not easy for the surgeon to determine whether the ligament or graft loop is punctured as described, supra, and/or whether the device has passed through the kink to properly anchor the tissue. Consequently, there is a need for more reliable and efficient procedures for such surgery and to avoid causing potential trauma to the tissue. It is therefore an objective of this invention to address this need.